Thursday, August 21, 2008

Olympian's Sister Awaiting Transplant

This is a sad commentary on Kaiser Permanente, the insurance carrier that is mentioned in this article. We will publish information on fund raising efforts for Amanda, as the information is received.

Olympian's sister sits in Anaheim, hoping for a new kidney
MORNING READ: Amanda Lappin cheers for her sister, Lauren, while holding out hope for insurance approval that could extend her life.

ANAHEIM Lauren Lappin has waited her entire life to live her dream, while her sister Amanda is dreaming just to live a normal life.

Lauren, 24, is in Bejing this week, a reserve infielder and back-up catcher on a U.S. Olympic softball team attempting to win its fourth consecutive gold medal. Amanda, 28, is in limbo. She spends much of her time getting dialysis while waiting for financial approval for a kidney and pancreas transplant. If she doesn't get healthy organs, she'll die sooner than she probably would otherwise.

"The irony is we have these athletes in the family and Lauren is at the pinnacle of her career," said Helen Valdez, the women's aunt and Amanda's care-giver. "And Amanda is at the lowest of her low."

Adding to her physical hurdles, Amanda, this month, is dealing with the emotional anguish of not being with the rest of her family to cheer on her sister.

"It's the moment that my sister's been working for and striving for her whole life," Amanda said through tears. "It's all coming to fruition right now in China, and I'm not able to be there to watch it. I would give anything to be there and experience it with my whole family."

And while Lauren is waiting for her chance to start a game, Amanda is waiting for her chance to finish her life.

Five years ago, doctors at UCLA Medical Center told Amanda that she needed a transplant, and she recently was put on the transplant list to get the procedure. But, last month, her insurance carrier said it wouldn't pay.

Valdez, working as Amanda's advocate, is taking the delay personally, spending hours on the phone every day trying to work out something for her niece.

"She's hooked up to a machine and she's 28 years old," Valdez said. "She's never been able to date a guy consistently and she'll never have children."

It Didn't Sink In

The Lappin family name is synonymous with sports at Loara High. Dean Lappin, Amanda and Lauren's father, is the Saxons baseball coach and Uncle David coaches the football team.

Lauren, the youngest of three Lappin children, played four sports, including softball and was selected as the Register's Female Athlete of the Year in 2002. The oldest, Archie, 29, starred in football, where he was selected Empire League Player of the Year in 1996, and went on to play football at Santa Ana College.

Amanda, the middle child, took what is, for the Lappins, a road less traveled. She joined the Saxons' dance team.

"We've always been really different," Amanda said. "We have different hobbies, but we still support each other."

But Amanda's life changed permanently at age 16 when she was diagnosed with Type 1 or juvenile diabetes. Amanda said the shock from the diagnosis was numbing.

"It didn't quite sink in. It felt like they were talking about someone else," she said. "When it did sink in, it was really hard for me."

Archie, then a senior in high school, was diagnosed with the same condition a month after Amanda. But the condition affected the siblings in different ways.

"He went right along with it," Amanda said. "It didn't affect him much, which kind of affected me more. It made me wonder why it was harder for me to deal with it."

As Amanda's condition worsened, Archie was setting passing records at Santa Ana College and Lauren was starting her athletic career at Loara.

"There's no jealousy. I'm proud of what they do and what they've done," Amanda said.

"I have to look at it as this is my situation and this is what I get to deal with."

While her siblings were starring, Amanda's organs began to fail.

"The assessment that time was to get her on a transplant list before Amanda had to start dialysis," Valdez said.

But that plan didn't work. Amanda's kidneys deteriorated to the point that at age 25 she was placed on dialysis. November will mark Amanda's third year of having to take the treatment. Each treatment lasts 3 hours, 15 minutes.

She can't eat many common foods, things as diverse as bananas and oranges, or dark sodas and bacon. Amanda says the toughest part of her diet is monitoring her liquid intake.

"I can only have 32-40 ounces of liquid between treatments, and that's really been a struggle. I used to chew on ice, so I have to factor that in. Popsicles, soup… Anything that would turn into liquid."

There in spirit

Amanda and her healthy sister are symbiotic in their inspiration of each other.

"She's told me how much I inspire her," Amanda says. "When she told me that, I said, 'Are you kidding? You're the biggest inspiration ever.'"

"Her focus and determination are just awe-inspiring. If you watch her in her element, you can see it in the way she talks and the way she walks."

Though Amanda can't physically be with her sister in Bejing, a piece of her is on the softball field. Before she left, Lauren asked Amanda to make her something she could wear while playing. Amanda made a bracelet.

"Just so that I know she's here with me and she knows that I'm there with her."

The rest of the Lappin family is in Bejing, in part, because this is Lauren's last shot at an Olympic Gold Medal. Lauren was an alternate for the 2004 Olympic team, and 2008 is the last year that softball is slated to be part of the Games.

Valdez said Amanda's time also is running short.

"She needs a transplant like yesterday. She's got to get this transplant before her body wears down anymore."

After the Olympics, Amanda says her sister plans to become a coach at the collegiate level. As for herself, Amanda's plans are simpler – just a transplant.

"From what I've heard, after transplants, people have more energy. They feel 110 percent better and I'm looking forward to that."

She said her ailments have made her stronger, but she's eager for a new challenge.

"I'm ready to put it in my past and move on to the next part of my life, and not have this on my back."

Friday, August 1, 2008

Guaranteed Issue Health Insurance

The state of California guarantees issuance of health insurance to any business of two or more owners/employees that qualifies according to the standards of the various insurance carriers within the state. What this means is that anyone with pre-exisitng medical conditions can obtain health insurance if they are an owner or employee of a legitimate business entity containing two or more persons.

A business can operate as a corporation, LLC, partnership, or sole proprietorship and obtain health coverage as long as at least two people are listed as officers or employees of the company. One insurance company will accept a legitimate business license as proof of eligibility, and a good health broker can consult with small businesses on whether they will qualify.

What this means is that those on expensive COBRA or HIPAA plans due to medical conditions may have an alternative to secure lower priced health insurance if they own a business. A business cannot be established for the sole purpose of procuring health insurance, however a legitimate business entity may be able to re-structure in order to qualify for group benefit programs.

I have consulted with many small business owners over the years and assisted them in establishing group benefit programs for their small business. The cost savings, in some cases, have reached 50% per month savings over COBRA premiums. If you own a small business or are self-employed and paying an exorbitant premium for health insurance, please contact me for a FREE no-obligation consultation. Don't let your health destroy your wealth.

John F. Pack
CA Insurance License 0D98889
949-400-4729 (cell)

Wednesday, June 18, 2008

The Healthcare Dilemma; Politics vs. Capitalism

One of the biggest problems with today’s healthcare dilemma is that we have two separate factions vying for control; the politicians whose prime objective is winning votes and support and the insurance companies whose prime objective is making a profit. The politicians espouse grandiose visions of universal healthcare for everyone without focusing on who will pay the bills, and the insurance companies preach freedom of choice and a privatized system while increasing rates and cutting benefits. The average consumer is caught in the middle with a big screw being constantly driven into the heart.

The question in this writer’s mind is “how do we bring these factions together to create an improved and functional healthcare system?” How do we create affordable healthcare for everyone without the healthy having to pay for the sick; the rich having to pay for the poor? The only real answer is compromise.

Let’s start by looking at the current system. One of the biggest problems that I face as a health insurance broker/consultant is the lack of uniform disclosure legislation requiring all insurance companies to state benefits and exclusions in a total and uniform manner. Some plans may exclude certain services that others may not. Some plans may not even offer an out of pocket maximum liability cap. Many times, possibly by design, the consumer is not made aware of these “exclusions” when purchasing a policy. Too often it’s all about making the sale. It is this writer’s opinion that insurance companies should be required by law to uniformly state the major benefits and exclusions of their plans without all the asterisks and fine print. I believe that an educated consumer who knows the limitations of the plan he or she is purchasing can make the proper decision on how to manage healthcare.

I also believe that there should be uniformity in legislative control as opposed to individual state management of healthcare. It is rather absurd to me that a person residing in California cannot transfer a policy to another state should he or she move to say Arizona. Federal legislative control will lead to more uniformity and better understanding for the consumer. Yes, this will require change from the insurance carriers, but some change is necessary and inevitable.

In order in guarantee coverage for the poor and the ill, a study should be undertaken to determine cost of universal care clinics to treat the poor and subsidies to assist in paying for those whose medical conditions preclude them from procuring individual coverage. The care clinics can be along the lines of what is being proposed and initiated by several large retailers where clinics are manned by registered nurses with rotating physicians on call for treatment of more serious issues. Those with certain declinable medical conditions would be eligible to receive subsidies to assist in paying higher premiums necessary to offset the overall risk factor involved in issuing them coverage.

In summary, this writer believes that a combination of universal healthcare and a privatized healthcare system should be the ultimate objective. Health insurance for everyone is a worthy and noble goal for this country. However, unless the insurance companies and the politicians can find a way to create compromise, the current system runs the risk of shifting to a much more costly system of healthcare management, and no one is focusing on the amount of this cost and who will be responsible for writing the check. There is no doubt that the American public in general is fed up with the current system, however they have not been offered alternatives that will actually work and be functional. It’s time to set aside the politics and profit motives and find a way to create positive and functional change.

John F. Pack
CA Insurance License 0D98889

Sunday, May 18, 2008

Facts you must know about COBRA

Most of us would have heard the term COBRA popping up when leaving a job, being laid off or in the process of a divorce. COBRA or the Consolidated Omnibus Budget Reconciliation Act of 1985 was instituted to allow people to continue health care insurance coverage provided by their employers even after they have retired or been terminated from work or by spouses after a divorce, as long as they pay the premiums themselves. This act, while a boon for those laid-off or divorced, is confusing to many. I’ve tried to simplify as much as possible a few salient facts about COBRA :

• You qualify for COBRA if you work for a company that has more than 20 employees, are covered under a group plan as an employee of the company who has retired or been terminated or a spouse, ex-spouse or a dependant child of such an employee.
• COBRA coverage does not last forever – you’re covered for up to 18, 29 or 36 months of coverage depending on both the qualifying event (termination, retirement, death or divorce) and the beneficiary’s status (employed, capable of earning). Termination or reduction of working hours enables you and your dependants for coverage up to 18 months, divorces, legal separation and death get your dependants 36 months of coverage, and dependant children who lose their dependant status get up to 36 months.
• Most people find insurance a more costly affair once they’ve signed up for COBRA after a lay off and wonder why. This is because your employer pays a part of your premium while you’re a full-time employee. So if thought your monthly premium was $350 and are presented with a bill for $663 at the end of each month when on COBRA, don’t be surprised or shocked. It only means that your employer has been paying $300 for you – the $13 is the 2 percent administrative fee you’re obligated to pay under COBRA. Before you sign up for COBRA, find out from your employer how much premium you have to pay each month.
• Don’t wait too long to find your own insurance even if your coverage under your employer’s plan lasts you for a long period of time. Start looking for alternatives at once. It’s going to be a difficult process, especially if you’ve just lost your main source of income. But consider the alternative - if you suffer a serious medical complaint in the time you’re still under your COBRA coverage, it’s going to be doubly hard and much more expensive to procure your own health insurance. Also, you may not get coverage for the said complaint and its related diseases in your new plan.
• You lose your coverage under COBRA if you’re eligible for Medicare, if you miss out on paying a premium, if your employer stops maintaining a group health plan or if you obtain coverage that is not subject to any limitations under another health plan.
• COBRA coverage is suited for those who are already being treated for some illness under the current plan and for those whose next employer does not offer healthcare coverage.
• If the beneficiary becomes disabled within 60 days of COBRA election, coverage is extended for another 11 months.
• While the first premium must be paid 45 days after election, you can pay other premiums monthly, weekly or quarterly.
• Federal employees are not covered by COBRA


Sarah Scrafford is an industry critic, as well as a regular contributor on the subject of RN. She invites your questions, comments and freelancing job inquiries at her email address:

Friday, April 4, 2008

Cut Health Insurance Costs Now!!!

HSA Major Medical Health Plans Offer Savings and Tax Benefits

Most of us are affected by today's economic environment, high gas prices, and the increasing costs of living. The health insurance industry is not exempt from increasing costs, however there may be an answer to controlling rate increases while maintaining health coverage and financial protection.

New health savings accounts (HSA's) represent a viable option for those searching for low cost health insurance. A health savings account is a special tax-sheltered savings account for medical expenses and is similar to an IRA in concept. Instead of purchasing high-priced health insurance with low co-pays, you buy lower cost health insurance (with a high deductible) for the "big bills" and deposit the difference in the HSA to cover the "small bills." Money deposited into health savings accounts is 100% tax deductible and can be easily accessed by check or debit card to pay medical bills tax-free including expenses not covered by insurance like dental and vision. Monies not used for medical expenses remain the property of the individual account holder, not the insurance company.

The benefits of health savings accounts are numerous and include the following:

Lower monthly health insurance premiums
More stability in premiums
Immediate tax savings
Long-term growth potential
Tax-free withdrawals to pay medical expenses
Tax-free withdrawals to pay for long-term care insurance or COBRA premiums
Freedom to choose your own medical providers
More control over your own healthcare decisions

If you are looking for low cost health insurance and have a desire not to pay high health insurance premiums while reducing federal income taxes, you should definitely contact us for more information on health savings accounts. Aetna, Blue Cross, Blue Shield, and PacifiCare all offer excellent HSA compatible plans. Health savings accounts are the wave of the future! You owe it to yourself to check them out!

For a FREE, no-obligation health quote, please email us the ages and home zip codes of all parties to be covered, any medical conditions or current medications, and information on your current health plan including deductible and monthly premium. We will be happy to run a comparison against several less costly HSA compatible plans. We also have a team of networking professionals who can also analyze your other insurance needs such as homeowners, auto, life, and disability coverage. Our focus is on serving our clients through high ethics, product knowledge, and professionalism.